Student Sign up

This is the individual sign up page. If you know the names of the seniors who would like to go you may fill it out for them. If you would like to reserve a number of spots please use the group sign up.

Name

First Name

Last Name

Email Address

Phone

(###)

###

####

Address

Your mailing address so we can mail you retreat information and resources.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Name of High School

Weekend

the date for this year's event

April 11-14, 2024

Gender

Male

Female

Photo Submitted

Send a senior photo or selfie to 541.595.8788 or tolife@life101.net

I have already sent it in

$50 Dollar Deposit

Deposit to leader/ paid below/ mailed

Deposit to leader

PayPal

Mailed to Life 101, PO Box 574 Sisters, Or 97759

Leader Name